Childbirth Education is being revolutionized by Injoy's recent production, Complete Childbirth Education Power Point Presentation. No longer does the childbirth educator have to drag charts, posters, videos cassettes, models, or even notes to the childbirth education classroom. The educator only needs a small case containing 4 CDs and a laptop computer. Of course, the facility must have the necessary equipment so that the information on the computer screen can be projected to a screen that is large enough to be viewed by several people at one time. With this program, those who manage and direct childbirth education programs will know exactly what is being presented in class, and, most of all, that the information being presented is correct.

Even though this program standardizes the class content, it still allows and mandates individual input from the educator and much opportunity for class participants to ask questions and input their thoughts. This presentation is information-rich as its name implies and yet sprinkled with laugh breaks, color cartoons, sound effects, dancing, pop-up and fading words, fun facts, and cultural diversity. There are no perineal shots and no actual birth scenes. Babies are shown breastfeeding, but little of the breasts are seen.

CD 1 : Pregnancy Topics, Pain Theories, Pre-Labor Signs

The first disk contains information on pregnancy topics, pain theories, and pre-labor signs. It begins with information that one would include in every first childbirth class - housekeeping information such as information about breaks, locations of supplies, and location of the bathrooms. Then there are a couple of cute ice breakers and the mission statement is presented: to learn about childbirth topics in a fun, comfortable, and respectful class environment. The program then moves into the curriculum: labor pain and pain theories, pre-labor, breathing and relaxation, and anatomy, explaining changes in pregnancy. At this point there is a little icon in the lower right corner noting that a one-minute, fifteen- second video is available for viewing that explains with more detail the last point, changes in pregnancy with moving graphics and narration. The educator can show it with a click on the icon. There are sound effects throughout the presentation, but narration is only heard when video is being shown.

The next topic is nutrition in pregnancy. Cartoons are used to demonstrate healthy foods. The pregnant woman only needs 300 more calories a day. The screen shows what kinds of foods equal 300 calories. Weight gain and fluid intake is covered. Danger signs are then presented in list format. The educator must click for each additional danger sign to be shown on the screen. The educator should read the list and make additional comments if appropriate. Rupture of membranes is one of the danger signs. The acronym COAT is given to the viewer as a reminder of what to report to the caregiver when reporting rupture of membranes: color, odor, amount, and time. A little cartoon picture of a coat appears on the screen to help the viewer remember the acronym. Facts about proper body mechanics appear on the screen. Optional: three 1 -minute videos are offered in the lower corner that include moving from bed and furniture, traveling in a car, and working at a desk. Advantages of Kegels appear on the screen, but no description of how to do them. The educator would have to describe how to do Kegels.

The next screen is Pregnane/ Topics Review and then Group Discussion with two discussion topics. The discussion topics are: 1 .) What is your previous experience with pain? and 2.) How do you imagine labor pain will be different from previous pain? The educator would facilitate the discussion and then click for the next topic. The cycle of fear, tension, and pain is shown with colorful letters. The educator must explain the screen. Another acronym is presented PAIN: purposeful, anticipated, intermittent, and normal.

The Four Ps of labor are shown: passageway, passenger, powers, and psyche. Great graphics accompany this topic. Early signs of labor, lightening, show, and prenatal bonding are well-reviewed. The educator has two options to explain prenatal bonding through visualization. The narrator can present the image in a less than 2- minute video or the educator can click on the "music only" icon and describe the imagery herself with soothing music in the background. The same option is available for the topic, progressive relaxation. The guided exercise is 5 minutes; the music only is 4 minutes. The first CD concludes with several breathing styles, again with wonderful graphics and sound effects. The cleansing breathe is mentioned, but not described.

Each CD ends with a short slide show of wonderful pictures of nature, mothers, babies, dads, and even grandmothers accompanied by soothing background music. Each picture has a heartfelt message, some from famous writers and some from unknown writers. The slide show is such a peaceful and positive way to end a childbirth class.

CD 2: Stages of Labor, Comfort Measures. Labor Positions

The second CD opens with a welcome exercise as an ice breaker. The topics for this class are listed. Onset of labor is described. As with the previous CD, the educator must read the screen and click after each point. Labor characteristics and its stages are easy to explain as the program proceeds because the facts listed are logical and complete and the accompanying graphics are excellent. Nature of contractions, sensations, support people's roles, best environment, length of labor, and emotions are presented. What to pack for labor is shown. The group members are asked about their support teams. The educator would again facilitate that discussion. A "Questions?" slide with cute babies is presented between basic topics. The videos on this CD include thoughts and advice from new mothers and fathers, and scenes with women in various labor positions being supported by the health care team and others.

Gate control theory is described as a preface to comfort techniques. Touch relaxation includes two videos. Again, a 3-minute one is narrated and a 4-minute one is music only. A massage video shows different types of massage and explains why massage comforts the laboring woman.

Attention focusing and distraction are both well-validated with two 30-second videos. One just shows a clock ticking away - 30 seconds which seems like forever. The second 30-second video shows various relaxing scenes of nature such as moving clouds in a beautiful blue sky and peaceful waterfalls. The second 30-second video seems to be much shorter.

The class content proceeds with a visual imagery exercise, focal point ideas, hydrotherapy, and tips for support partners. Slow breathing is reviewed with graphics and sound effects. Many labor positions are shown and avoidance of back-lying is emphasized. Labor positions are shown and described with a discussion of how certain positions can even enhance labor. Paced breathing and patterned breathing are shown with graphics suggesting when each would work best. Discussion of how to use a birthing ball is included. The last part of CD 2 includes tips for coping with back labor, breathing during pushing, and positions for pushing.

The CD ends again with another wonderful short slide show. One slide show message is "breast milk is soul food" and another is "a father carries pictures where his money used to be."

CD 3: Interventions, Pain Medications, Cesarean Birth

Another welcoming exercise opens this CD and then presents the topic of this CD: what a birth plan is and is not. Group discussion follows: Have you prepared a birth plan?

Interventions may be necessary, but questions should be asked before they are done. An excellent list is presented to the viewers, which includes the risks and benefits and what would happen if one decided to wait. Inductions should not be for anyone's convenience. Additional topics on this CD that are presented well are augmentation, amniotomy, intravenous fluids, external and internal electronic fetal monitoring, fetal scalp sampling, vacuum extraction, forceps, analgesics, and epidural anesthesia. Not all sub-topics are described perfectly, but each has excellent graphics so the educator could easily fill the informational gaps. Benefits and risks are listed for each.

Extended time is spent on epidural anesthesia as well it should be because of its worldwide popularity. A 4-minute video shows the administration position with excellent graphics. The needle insertion is not shown on the laboring mother during the video; the injection is only shown on the graphic. Epidurals should not be administrated before 4-5 cms vaginal dilation. The viewer is advised to wait a bit after full dilation before pushing. Risks and benefits are presented with this intervention also.

Cesarean is also well-covered with information, graphics, and videos. There are two videos, one of an unplanned cesarean and the other of a planned cesarean. One suggestion given on how to avoid a cesarean is hiring a doula. The slide show at the end of this CD is especially appreciated by this grandma reviewer as one of the slides shows a grandma with a baby and a quote from Theresa Bloomingdale, "If your baby is beautiful and perfect, never cries or fusses, sleeps on schedule, burps on demand, an angel all the time... you're the grandma."

Another welcoming exercise opens this video along with information about the topics included on this CD. Postpartum physical and emotional characteristics are covered well. Comfort measures are included; including ice packs the first day and then Sitz baths. Two short videos are optional that well explain postpartum blues which occurs in 80% of new mothers and another on the more serious postpartum depression. Dads can also feel blue after the baby is born. Excellent advice is given to those women who feel depressed or frustrated with the overwhelming new responsibilities that go along with caring for a newborn. Newborn appearance and required newborn medical procedures are reviewed. A baby's innate ability to respond to the environment is nicely explained. The six stages of baby consciousness are reviewed using movies of babies. A baby is shown trying to shut down the surrounding stimuli.

Shaken baby syndrome is presented outstandingly. One suggestion given for the caretaker is to hug a pillow when frustrated, and to pray or breathe deeply. Of course, the best suggestion is to ask for help in caring for a new baby and move out of the environment if necessary until one has calmed down. Recommendations for preventing sudden infant death syndrome (SIDS) are listed.

Breastfeeding begins with a group discussion about the knowledge and the attitude that the group already has. Then basics facts are covered well. Again, using graphics, proper latch-on and positioning methods are reviewed. Advantages of breastfeeding, when to feed, and positioning for feeding are nicely covered. A fun fact that is mentioned is that holding a baby for more than two hours skin-to- skin after birth can increase breastfeeding success by 80%.

The last CD concludes with a refresher labor rehearsal, reviewing each type of breathing pattern and when they can best be used. Comfort measures and encouragement are emphasized. A final slide show of cute babies and sweet messages are the very last of the fourth and final CD.

The PowerPoint presentation solves so many of the previous unsolvable problems of educators. Having appropriate posters in order while lecturing has always been difficult; so too is comparing one poster to another. Frequently, when explaining anatomy, the educator would use one or two 2-dimensional posters plus the educator's own body and then a three-dimensional model. How confusing that could be to the learner! The mechanics of moving from lecture to group discussion to videos could often result in loss of the learners' attention. All educators know that it is difficult for a term pregnant woman to sit for 20- to 30-minute movies and yet much information was best understood if it could be presented in moving picture form. Educators want their class members to see a real person in labor using suggested comfort techniques. Pregnant couples want advice from new parents as well as health professionals.

The video clips in this CD package are not longer than 5 minutes, yet every necessary scene is shown during the PowerPoint presentation. Because posters are cumbersome, educators use them only if necessary and yet research tells us that most people are visual learners. This PowerPoint presentation lists every fact on the screen. As the educator reads it, the viewer reads it in their mind and sees it. The more senses used, the more that is learned. Because the educator has power over the click to move to the next fact, the educator determines the unique pace of that particular class. The extroverts in the class will probably ask questions any time, but the introverts will probably wait until the cute baby "Questions?" or "Review" slide comes up, especially if the educator waits and allows silence for a few seconds at this time. The educator can give the class a break at any time. Instead of asking vis a vis questions during class breaks, many educators are preparing to show a video or coordinate other visual aids for the second half of class content. This will not happen with this media package. Breaks can become a time for answering one-on-one questions from learners with unique problems. The class resumes with a simple click.

There were a few graphics that were too dark and at one time the words were out of sync with the talker in a video. Perhaps Injoy can fix those small defects. Injoy is also available to customize this program to fit your teaching needs for a one-time fee of $99.95. If more than one person is using the program a facility can purchase an additional user license for $99.95. An excellent facilitator's guide comes with the CD package which includes pictures of all the slides and PowerPoint tips.

This is not a "take home" audiovisual birth preparation media. Although it covers all the necessary information of a childbirth education class, it still needs a knowledgeable educator to present it. This is a very expensive program to produce and it is one that could only be produced by experts in the media field. All efforts should be made to avoid copyright infringement. Injoy deserves to recover its production costs plus a profit so that they will continue to offer educators quality, current media.

This reviewer has reviewed hundreds of childbirth education audiovisual aids and has never been as excited about using a new educational media as she is about using this one. Most childbirth educators will delight in using this new media.

Most childbirth educators will delight in using this new media.

Copyright INTERNATIONAL CHILDBIRTH EDUCATION ASSOCIATION Sep 2007

(c) 2007 International Journal of Childbirth Education. Provided by ProQuest Information and Learning. All rights Reserved.